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Path - Intro + Overview of Benign + Malignant Neoplasms (i) (intro…
Path - Intro + Overview of Benign + Malignant Neoplasms (i)
intro
neoplasm= new growth due to uncontrolled cell prolif - abnormal regulation of cellular signalling
a tumour can be a lump/mass from any cause (neoplasm/haematoma/abscess/scar
controlled cell prolif = hyperplasia (often physiological, e.g. endometrium in menstrual cycle, or pathological, e.g. smooth muscle in airways in asthma)
neoplasia = uncontrolled cell prolif
autonomous (doesn't rely on external signals)
purposeless
progressive
parasitic (uses body's nutrients)
reasons for dying from cancer
infection (e.g. lung cancer + pneumonia)
organ failure
mets to brain (coning)
top killing cancers
men: lung, colon (screening effective), prostate (screening not effective)
women: breast, colon, lung
most common cancer = non-melanoma skin cancer (rarely mets/kills)
Neoplasm classification
benign
grow but can't met
hence usually cured with surgical resection unless site is inoperable (e.g. brain)
confirmed by pathological assessment (macro + microscopic features)
well-circumscribed, often encapsulated (pseudo capsule), rare haemorrhage/necrotise
can become malignant if an additional mutation permitting invasion occurs (rare except in colon adenomas can become carcinoma)
Epithelial
papilloma = squamous
skin, mouth, anus, oesophagus, pharynx, larynx (symptom = hoarseness), cervix
adenoma = glandular/columnar
thyroid, rest of GIT, liver, kidney, great, endometrium, ovary (cyst), uterus
transitional/urothelial papilloma
ureter, bladder, urethra
Connective tissue
lipoma
neuroma
angioma
chrondroma
leiomyoma (smooth muscle fibroids, e.g. uterine)
cause death by severe blood loss
spread locally into adjacent tissues by pressure
malignant
haemorrhage due to angiogenesis
necrotise due to rapidly increasing cell nos all requiring O2 (rate of prolif exceeds blood supply)
more necrosis -> more aggressive -> higher grade (less differentiated)
microscopic features
nuclear features
pleomorphism (nuclei of varying shape/size in 2 adjacent cells)
hyperchromasia (darker)
increased mitotic activity
increased nuclear:cytoplasmic ratio (increased nucleus size)
architectural features
disruption/loss of maturation
degree of differentiation is how tumours are graded (prognostic feature)
primary
90% carcinoma
3% lymphoma
1% sarcoma
secondary (mets)
borderline
v rare
mainly in ovary
show some nuclear features suggesting malignancy, but not enough to be certain it will behave as a malignant neoplasm
no such thing as benign lymphoid neoplasms (benign lymphoma)...
can always met as they are in the bloodstream